“Willfully Disobeying The Law”: Republican Leaders Refuse To Make Appointments To Key Obamacare Panel
The top two Republicans in Congress informed President Obama on Thursday that they will refuse to fulfill their duty under the Affordable Care Act to recommend members of a new board with the power to contain Medicare spending.
It’s a dramatic power-play driven by the explosive partisan politics of Obamacare and with potentially important implications for federal health care policy.
In a letter to President Obama, House Speaker John Boehner (R-OH) and Senate Minority Leader Mitch McConnell (R-KY) noted their original opposition to Obamacare, reiterated their intent to repeal it entirely, and declared that they would not make any appointments to the Independent Payment Advisory Board.
The IPAB is a 15-member panel whose members must be confirmed by the Senate. The President selects three members himself and is required by law to seek three recommendations each from the top Democrat and Republican in each chamber. With Thursday’s letter, Boehner and McConnell refused to make any recommendations.
The IPAB will be stood up in 2014 by Obamacare and tasked with making cuts to Medicare provider payments (it may not touch benefits) if costs exceed economic growth plus an additional percentage point in any given year. Congress can override it by passing equally large cuts with a simple majority or waiving the cuts entirely with a three-fifths majority.
“Because the law will give IPAB’s 15 unelected, unaccountable individuals the ability to deny seniors access to innovative care, we respectfully decline to recommend appointments,” Boehner and McConnell wrote in the letter.
But there is a catch: if IPAB fails to do its work for any reason, the Health and Human Services secretary must order the cuts herself. So in a way, Boehner and McConnell are surrendering some of their power in order to appear as though they’re thwarting Obamacare — when in reality they’re merely turning over more control to the executive branch.
“Under the ACA, if the IPAB fails to make a recommendation as required under the IPAB provision, the Secretary may make a recommendation in its place,” said Tim Jost, a professor of health law at Washington and Lee University. “So if no IPAB is created, it is not fatal.”
IPAB is, however, capable of functioning without all of its members confirmed. But the letter reflects a continuation of broader GOP obstruction of Obamacare implementation. Senate Republicans have suggested that they may filibuster any IPAB nominee, period.
This approach makes it easier for a future Republican president to neuter IPAB by executive fiat. In the short term, it puts the Obama administration more directly in the political line of fire for any cuts that it does approve.
The other political incentive for Republicans to oppose IPAB is that spending Medicare dollars more wisely makes it easier to sustain the single-payer structure of the program, and makes it harder to argue that it needs to be privatized, as the Paul Ryan budget does.
There is some irony as well in Boehner and McConnell refusing to play ball on IPAB — a key cost containment mechanism in Obamacare — while their party is complaining about potential cost increases under the law, and government spending more generally. Limiting Medicare spending and cutting the deficit, part of the rationale for IPAB, are routinely touted as central GOP goals.
“We believe Congress should repeal IPAB, just as we believe we ought to repeal the entire health care law,” Boehner and McConnell wrote. “In its place, we should work in a bipartisan manner to develop the long-term structural changes that are needed to strengthen and protect Medicare for today’s seniors, their children, and their grandchildren. We hope establishing this board never becomes a reality, which is why full repeal of the Affordable Care Act remains our goal.”
By: Sahil Kapur, Talking Points Memo, May 9, 2013
“Facing Republican Intransigent Extremism”: How President Obama Can Still Win In Washington
The Washington pundits of the moment – a group that includes such blinding lights as Maureen Dowd and Ron Fournier – seem to believe that if only President Obama would provide adequate “leadership,” the partisan polarization on Capitol Hill would evaporate and America’s problems could be solved at last. While the president rightly mocked this notion as a fantasy worthy of Hollywood’s Aaron Sorkin, it does raise the vital question, however obtusely, of what Obama might do as he confronts an oppositional Republican-led Congress.
Whatever the punditocracy may imagine, there is no way for Obama to force his agenda on the Republicans in the House and the Senate, who range from scheming partisans like Mitch McConnell and Eric Cantor to Tea Party zealots like Ted Cruz and Michele Bachmann. Unlike Abraham Lincoln or Lyndon Johnson, the two brilliant manipulators with whom he is sometimes compared and found wanting, the president is not equipped to bribe, blackmail, or herd in the style of those Machiavellian chief executives. If he were so equipped — and indeed used his power as ruthlessly as Lincoln or Johnson — the same pundits who now complain that he isn’t controlling the agenda would shriek about his misuse of power.
In this journalistic mindset, the president (especially a Democratic president) is always wrong; using power is bad/unethical/cynical, while failing to use power is weak/aloof/naïve. Both ends of this stick have been repeatedly applied to Obama, of course, just as they were constantly used to punish Bill Clinton.
Alternatively, those calling for presidential “leadership” — especially the oh-so-serious Beltway types — want Obama to prove his bona fides by abandoning Democratic programs and principles, even though the Republicans have showed no willingness to cross their redline on taxes. In fact, the president has offered an excess of compromise already, while failing to elicit any fresh initiative from the opposition. Yet somehow, in the pundit mindset, Obama and the Republican leadership are equally at fault.
The president understands that critics who play such jejune Beltway games don’t deserve much of his time or attention, unless they can serve as absurdist foils for a funny dinner speech. The most salient fact in American political life is (and for some time has been) the intransigent extremism of the Republican Party. Any columnist who tries to ignore or excuse that extremism has nothing useful to tell any president.
What Obama evidently doesn’t understand, despite years of bitter experience, is the significance of that right-wing extremism for someone like him, whose nature is to accept differences and seek compromise. Unable to negotiate with a reasonable counterpart on either side of the Hill, he too frequently negotiates with himself – whether over Obamacare, the debt ceiling, the budget, deficit reduction, taxes, or “reforming” Social Security.
Yet whenever he discards a progressive position, such as the public option in health care, or adopts a conservative position, such as reducing Social Security cost-of-living increases, he only succeeds in demoralizing his base. Meanwhile, rejection by the Republicans is preordained.
So what is left for President Obama to do if he wishes to see any of his second-term agenda enacted? By now he ought to have noticed that when he speaks out firmly on behalf of progressive principles, in support of working families, his polling numbers improve and his power increases. (And whenever he vacillates, his numbers diminish and his authority weakens.)
The recent battle over gun background checks indicates that even some of the most reactionary Republicans – like Pennsylvania senator Pat Toomey, formerly of the Club for Growth – can be pushed into supporting sensible reform. But that doesn’t mean seeking a “grand bargain” with politicians who want no bargain at all. It does mean mobilizing citizens on the largest possible scale, every day; it means making sure they know that the president is on their side, shares their values, and will uphold his promises to them. It means explaining to the American people, with fearless candor, that the Republican Party is unfit to participate in national governance – and unless that party is defeated decisively next year, no important objective can be achieved.
By: Joe Conason, The National Memo, May 3, 2013
“It’s Official, The Tea Party Is Back”: Once Again, Fantasies Of A Pragmatic GOP Prove Illusory
Say what you will about Politico, but aside from the many bits of useful phenomenological data its vast minions gather each day, it serves as a sort of public utility in instantly and thoroughly expressing the shifting perspectives of the MSM. Today, having misinterpreted and buried the Tea Party Movement a thousand times, Politico (in this piece by Tarini Parti) now takes judicial notice of its return on Capitol Hill:
The Tea Party Caucus is back in action with a new strategy and a growing membership.
Roughly 20 House Republicans attended a closed-door meeting Thursday evening in the Rayburn House Office Building, along with staffers from nearly 40 congressional offices, including those of Senate Minority Leader Mitch McConnell and fellow Kentucky Republican Sen. Rand Paul.
It comes as conservatives continue to flex their muscle, making life difficult for GOP leaders in the House on issues like Obamacare, and as the debate on immigration legislation heats up.
Conservative mainstays such as Reps. Paul Broun (R-Ga.), Louie Gohmert (R-Texas), Tom Price (R-Ga.), Trent Franks (R-Ariz.) and Steve King (R-Iowa) were among those at the meeting. A source said the entire GOP House delegation from South Carolina was there as well.
Mike Shields, chief of staff to Republican National Committee Chairman Reince Priebus, spoke at the meeting – an indication that the GOP establishment is making an effort to work with the tea party lawmakers.
Also in attendance: Conservative radio talk show host Rusty Humphries and representatives from organizations including the Tea Party Express and U.S. Chamber of Commerce. TheTeaParty.net organized the meeting, which was closed to press.
The possibility that high attendance at the caucus meeting might reflect a continuing presence rather than a sudden resurgence was indirectly addressed by this quote from Louie Gohmert:
“I thought it was the energy we had when we first started things,” Gohmert told POLITICO after the meeting. “The Tea Party beliefs and movement never really went away. It was just that the caucus wasn’t really having meetings.”
True dat. You could make the case, in fact, that the relative quiescence of the Tea Party Caucus was attributable to its consolidation of power within the Republican “Establishment.” Now that strategic disagreements within the congressional GOP are re-emerging, it’s time to get loud and proud again. But the whole phenomenon shows how shallow all the talk about the GOP “rebranding” and “adjusting to new circumstances” really was–much less the fatuous chatter about “bipartisan breezes wafting through Congress.”
It’s entirely possible, not soon but in the foreseeable future, that the Republican Party and even the conservative movement can genuinely move beyond the “Spirit of 2010” and begin to act like a political party rather than a wrecking crew. But anyone who has paid genuine attention to the Tea Party Movement must understand that these are people who violently oppose the idea of “moving on” or “adjusting to circumstances.” The whole point of “constitutional conservatism” is the belief in an eternal, perhaps even divinely ordained, governing model that never, ever, goes out of season. Maybe they’ll lose influence in the GOP and the country as a whole, but they aren’t going away or changing. Their periodic rediscovery by the MSM when once again fantasies of a “pragmatic” GOP prove illusory is one of the maddening but abiding aspects of contemporary political journalism.
By: Ed Kilgore, Contributing Writer, Washington Monthly Political Animal, April 26, 2013
“Before A Rooster Crows, Will They Be Denied?”: Newtown Families Ask For Meeting With Mitch McConnell
A representative for families of the Newtown shooting victims has asked Senator Mitch McConnell to hold a meeting with them, according to sources familiar with the request. McConnell’s office initially declined the request on the basis of scheduling, a source says — and now family members are set to call McConnell and reiterate the request personally.
How will McConnell respond?
The request – if granted — would allow the families to come face to face with the primary architect of the GOP’s strategy of blocking everything Dems propose to slow the tide of gun violence. If it is denied, it would be a big story, and could lend support to the argument that Republicans are callously rebuffing the families — and prioritizing the gun lobby over them – in the wake of a massacre that claimed the lives of 20 Newtown children.
The request — which was made by a representative of Sandy Hook Promise, a group that includes around a dozen family members who are lobbying Washington lawmakers – represents something of a shift in strategy by the families, and carries interesting implications for later stages in this battle. Previously, the families, who had met with many Democratic and Republican Senators, had shied away from asking for a meeting with McConnell, on the theory that they should focus their energy on Senators they deemed persuadable. This irritated Democrats who wanted to see more public pressure put on their GOP counterparts.
But now the families are asking McConnell for a meeting. The families are not optimistic that the meeting will move McConnell, a source familiar with their thinking says, but this will placate Dems who want public pressure put on the leader of Senate Republicans. What’s more, if the legislation fails, the families don’t want to be in the position of retrospectively wondering if they had done all they could to get it passed, particularly since a round of bitter finger-pointing would be all but inevitable. And finally, the source says, the families are hoping to initiate a longer term conversation — one beyond the current battle – with even hostile lawmakers about other ways of combatting gun violence, such as school safety and addressing mental illness.
Asked for comment, McConnell spokesman John Ashbrook emailed me this:
Our office recently sat down with folks from Newtown for a lengthy discussion and we’re certainly open to doing it again. We actually offered another meeting and are waiting to hear back.
It’s unclear which Newtown residents this refers to or whether McConnell is willing to meet personally with families.
There’s another angle worth considering here, too. While McConnell obviously wants to sink the Manchin-Toomey background check proposal via procedural means — whether by filibuster or by voting it down as an amendment, which would require 60 votes to pass – Democrats and gun control advocates believe he wants a few red state Dems to oppose it in the procedural vote, too. That would mean that the proposal was blocked by a bipartisan group of Senators — insulating the GOP from some blame — as opposed to meaning it was defeated solely by Republicans who were determined to avoid allowing it come to a simple majority vote.
If the families put more pressure on McConnell, it won’t move him, but it could perhaps make it tougher politically for the GOP alone to sink the proposal. And so, if the remaining hold out red state Dems ultimately do support moving the bill forward past the next supermajority procedural vote, it would then become harder for the remaining Republican holdouts — Kelly Ayotte and Dean Heller — to vote No, because then the blame for killing the whole proposal by procedural means would fall on the GOP.
By: Greg Sargent, The Plum Line, The Washington Post,April 16, 2013
“Sabotaging Gun Control”: Fighting For His Political Life, Mitch McConnell Has Wayne LaPierre’s Back
I owe Senate Minority Leader Mitch McConnell a minor apology. I said he was being very silly when he demanded an FBI investigation into the recording of a meeting at his campaign office. In fact, the meeting actually was surreptitiously recorded by his political enemies, or at least by a guy who operates a useless “super PAC” that has, thus far, spent a total of $18 on defeating McConnell. McConnell probably didn’t lose much sleep awaiting my apology, though, because the recording, and the news of its provenance, are just about the best things that have happened to the guy since the D.C. circuit court gave McConnell veto power over all of President Obama’s appointments.
McConnell’s very good week might not end up meaning very much, though, if the United States Senate manages, somehow, to pass major legislation on gun control and immigration any time soon. Because whenever the United States Senate manages to accomplish anything, conservatives get very irate with Mitch McConnell for allowing it to happen.
McConnell is reviled by the right-wing activist base, for reasons that, honestly, I don’t quite get. McConnell is up for reelection next year. He is working right now to prevent the possibility of a serious primary challenge. He’s succeeding, so far, but candidates have until next January to make up their minds. That’s a lot of time for some “Ron Johnson type” to emerge.
(It is a bit unusual for a Republican Senate leader to be in such a precarious electoral position. Republicans are generally smarter than Democrats when it comes to selecting leaders who aren’t under the constant threat of losing their next election. Harry Reid has proven himself to be a competent Majority Leader in some ways, but the fact that he answers to Nevada voters makes him quite willing to ignore liberal priorities on any number of issues. McConnell, like many Republican members of Congress, is more vulnerable to a primary challenge than a Democrat, though he’s unpopular enough to need to fear both.)
With 2014 in mind, it’s easy to see why McConnell refuses to meet with Harry Reid, even in private. (That’s also news that McConnell will not mind seeing reported.) And it’s why McConnell is going to do everything in his power to derail the gun control compromise currently being negotiated by Sens. Joe Manchin and Pat Toomey. Politico has a special preview of the horrible amendments McConnell will add in order to blow up the bill:
Sen. Chuck Grassley (R-Iowa) is drafting an alternative gun bill that could peel away GOP support, and McConnell may attempt to force votes on allowing guns in federal buildings and national parks, or the creation of a national “concealed carry” standard.
If McConnell wins, if recent history is any indication, he won’t get much credit from the right. If he loses, and a gun bill passes the Senate, he’ll get pilloried. Even if the bill goes nowhere in the House. Doing the (nationally) unpopular thing and sabotaging this very popular bill is basically a no-brainer for McConnell, which is likely why gun control advocates never even bothered to lobby him.
Everything McConnell is doing is about a potential primary election. As Roll Call says, a big part of McConnell’s strategy is to act as much like Rand Paul as possible, because Rand Paul is quite popular. On guns, it’s quite easy for McConnell to back Paul. It’s harder to say, though, what McConnell will do about the immigration reform compromise. Paul supports citizenship opportunities for currently undocumented immigrants. Right-wingers used to call that “amnesty,” and they hate it. McConnell has not yet given any hint of what he’ll do once the “Gang of 8″ finally unveil a proposal.
If you understand McConnell’s actions as purely, nakedly political, and basically devoid of “principle” or even ideology — his purpose in obstructing all Senate business during Obama’s first term was defeating Obama, not advancing conservatism — immigration reform will be an interesting experiment. He could win conservative cred by opposing it — right-wing darling Ted Cruz is making himself the face of opposition to the proposal for a reason — but he may not want to appear in any way opposed to Rand Paul, his most important political ally. (Paul could make McConnell’s decision easier and come out against the proposal. We’ll see!)
So, for the next year and change, the primary goal of the Senate minority leader will be avoiding or winning a primary against a very right-wing challenger. Which is why this bit of news, reported in Roll Call, is so curious. Apparently McConnell gave a secret speech last week to the National Urban League, the venerable black civil rights community organization.
McConnell’s address to the National Urban League, for example, sounded a lot like Paul’s at Howard. According to a source familiar with McConnell’s speech, the leader told the room of black business leaders: “I want to see a day when more African-Americans look at the issues and realize that they identify with the Republican Party.” That message echoed Paul’s at the historically black university.
McConnell also dedicated time to talking about Sen. Tim Scott, R-S.C., telling the crowd in the Kennedy Caucus Room of the Russell Senate Office Building that Scott is an African-American who has realized the strength of GOP politics. It doesn’t hurt McConnell’s case with the right that Scott also happens to be a tea party conservative.
If the point was to imitate Rand Paul’s speech at Howard University, keeping it so quiet is confusing. (Or maybe it wasn’t a secret and actually it’s just that no one cared to cover it until now.) Conservatives do love it when their heroes tell “hard truths” to unfriendly audiences (like racial or ethnic minorities) but this sounds like a very uneventful address. Maybe Mitch McConnell does care about more than just maintaining his grip on power! Just don’t expect him to demonstrate any other interest when it comes to all Senate business conducted between now and May 2014. The silver lining to that news, though, is that he could end up killing any grand budget bargain.
By: Alex Pareene, Salon, April 15, 2013
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